Alex Trebek has pancreatic cancer: Here's what you should know

PORTSMOUTH — Last week Alex Trebek, longtime host of the popular game show Jeopardy, announced he has stage 4 pancreatic cancer.

Trebek publicly announced his intention to fight the disease and to keep on working.

“We wish him well,” said Dr. Panagiotis Fidias, an oncologist and Medical Director for oncology/hematology at Exeter Hospital’s Center for Cancer Care. “There are no big breakthroughs in pancreatic cancer, but there have been a few incremental wins.”

Fidias said they see quite a few pancreatic cancer cases and cancers in general at Exeter Hospital.

“We talked with the state, through Dr. Tom Sherman, who works here and is a state senator,” said Fidias. “The state did a study of cancer trends in New Hampshire and said there does not seem to be an increase, but I think we see a lot of cases. In this case, pancreatic cancer is aggressive and not up there with cancers that have seen breakthroughs.”

Dr. Yuko Fukuda, an oncologist at Portsmouth Regional Hospital, said the odds of remission are not great. She said Trebek's intention to continue working will be challenging.

“Pancreatic cancer is diagnosed in 55,000 people a year in the United States,” said Fukuda. “It is not the most common cancer, but it is the eighth leading cause of cancer deaths worldwide. It is a highly aggressive disease. Even with aggressive treatment the response rate is only about 30 percent.”

Fidias said that if the cancer is found earlier, surgery would be his first line of treatment, with chemo and radiation both before and after the surgery.

Stage 4 pancreatic cancer means the disease has metastasized to other parts of the body. Fukuda said the most common is a spread to the lungs or the bones.

“Stage 4 means the disease is outside of where it originated,” said Fukuda. “It can go almost anywhere. In stage four the disease does not go into remission. We can just try to control the disease until the person is too weak to tolerate treatment, or they are having too many side effects from the chemo. Surgery is not really an option at this point.”

Fukuda said there are no good screening tools for pancreatic cancer, so by the time most people are diagnosed, they are already in an advanced stage of the disease. She said much research still needs to be done on pancreatic cancer because there are “no home runs” yet.

“There is believed to be a genetic component of the disease,” said Fukudo. “The BRCA gene, widely recognized in breast cancer, appears to also have a link to pancreatic cancer. A person with the BRCA gene has an increased risk of getting pancreatic cancer.”

Other factors possibly linked are smoking, a lack of physical activity and pancreatitis (associated with alcoholism).

“There are no clearly defined symptoms,” said Fukuda. “Pancreatic cancer often starts at the head of the pancreas. In some cases, people can become jaundiced, with yellowish skin and eye color. Dark urine can be an indicator. Bad back pain that doesn’t go away can be a sign, but they can all point to something else. Really this is a silent killer because it starts deep in the body and is not easily noticeable.”

Fukuda said even in patients who are treated in the earlier stages, about 55 percent will see the cancer return, even after very aggressive chemotherapy.

“If someone is very fit and active, we can try a more aggressive treatment,” said Fukuda. “Others cannot tolerate it. With this type of cancer, we will have the conversation about quality of life. Is it better to be as aggressive in treatment, which has its own problems, or to make the best decisions for the person’s quality of life.”

“Chemotherapy has its own ups and downs," said Fidias. “Some people can tolerate it and others cannot as well. Some patients with this disease can live for longer terms. For most though, survival is short, a year or so.”

The most recent attempts to find an answer to pancreatic cancer involve efforts to identify subgroups of the disease.

“So far that has been elusive,” said Fidias. “One subset may be genetics, but that factor might be as small as 2 percent. That’s not a lot. Even so, national guideline changes this year call for every case of pancreatic cancer to be genetically tested, as a place to start. This will take some time, finding the answers.”

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.